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Publicações

Publicações por LIAAD

2022

Impact in the quality of life of parents of children with chronic diseases using psychoeducational interventions - A systematic review with meta- analysis

Autores
Rodrigues, MG; Rodrigues, JD; Pereira, AT; Azevedo, LF; Rodrigues, PP; Areias, JC; Areias, ME;

Publicação
PATIENT EDUCATION AND COUNSELING

Abstract
Objective: This study aimed to identify psychoeducational interventions applied to parents of children with chronic diseases and evaluate their impact on their quality of life (QoL). Methods: It was conducted in six databases, complemented by references from the included studies and other reviews, manual search, and contact with experts. We included primary studies on parents of children with chronic diseases that studied psychoeducational interventions versus standard care. Results: We screened 6604 titles and abstracts, reviewed the full text of 60 records, and included 37 primary studies. Half of the studies were on Asthma. We found three intervention formats: one-to-one (43%), groups (49%), and combined approach with individual and group settings (8%). More than 60% of the included studies found statistically significant differences between the intervention and the control group (p < 0.05). Conclusion: Several interventions have shown efficacy in improving parental QoL. Despite that, there is insufficient evidence of interventions' implementation. Practice implications: A holistic approach encompassing the patient and the family's biopsychosocial dimensions is fundamental in successfully managing chronic disease in children. It is vital to design and implement interventions accommodating the common issues experienced by children, parents, and families that deal with chronic childhood conditions. Systematic review registration number PROSPERO 2018 CRD42018092135.

2022

Biomarkers for Alzheimer's Disease in the Current State: A Narrative Review

Autores
Gunes, S; Aizawa, Y; Sugashi, T; Sugimoto, M; Rodrigues, PP;

Publicação
INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES

Abstract
Alzheimer's disease (AD) has become a problem, owing to its high prevalence in an aging society with no treatment available after onset. However, early diagnosis is essential for preventive intervention to delay disease onset due to its slow progression. The current AD diagnostic methods are typically invasive and expensive, limiting their potential for widespread use. Thus, the development of biomarkers in available biofluids, such as blood, urine, and saliva, which enables low or non-invasive, reasonable, and objective evaluation of AD status, is an urgent task. Here, we reviewed studies that examined biomarker candidates for the early detection of AD. Some of the candidates showed potential biomarkers, but further validation studies are needed. We also reviewed studies for non-invasive biomarkers of AD. Given the complexity of the AD continuum, multiple biomarkers with machine-learning-classification methods have been recently used to enhance diagnostic accuracy and characterize individual AD phenotypes. Artificial intelligence and new body fluid-based biomarkers, in combination with other risk factors, will provide a novel solution that may revolutionize the early diagnosis of AD.

2022

Partial Multiple Imputation With Variational Autoencoders: Tackling Not at Randomness in Healthcare Data

Autores
Pereira, RC; Abreu, PH; Rodrigues, PP;

Publicação
IEEE JOURNAL OF BIOMEDICAL AND HEALTH INFORMATICS

Abstract
Missing data can pose severe consequences in critical contexts, such as clinical research based on routinely collected healthcare data. This issue is usually handled with imputation strategies, but these tend to produce poor and biased results under the Missing Not At Random (MNAR) mechanism. A recent trend that has been showing promising results for MNAR is the use of generative models, particularly Variational Autoencoders. However, they have a limitation: the imputed values are the result of a single sample, which can be biased. To tackle it, an extension to the Variational Autoencoder that uses a partial multiple imputation procedure is introduced in this work. The proposed method was compared to 8 state-of-the-art imputation strategies, in an experimental setup with 34 datasets from the medical context, injected with the MNAR mechanism (10% to 80% rates). The results were evaluated through the Mean Absolute Error, with the new method being the overall best in 71% of the datasets, significantly outperforming the remaining ones, particularly for high missing rates. Finally, a case study of a classification task with heart failure data was also conducted, where this method induced improvements in 50% of the classifiers.

2022

Enabling Early Obstructive Sleep Apnea Diagnosis With Machine Learning: Systematic Review

Autores
Ferreira Santos, D; Amorim, P; Martins, TS; Monteiro Soares, M; Rodrigues, PP;

Publicação
JOURNAL OF MEDICAL INTERNET RESEARCH

Abstract
Background: American Academy of Sleep Medicine guidelines suggest that clinical prediction algorithms can be used to screen patients with obstructive sleep apnea (OSA) without replacing polysomnography, the gold standard.Objective: We aimed to identify, gather, and analyze existing machine learning approaches that are being used for disease screening in adult patients with suspected OSA. Methods: We searched the MEDLINE, Scopus, and ISI Web of Knowledge databases to evaluate the validity of different machine learning techniques, with polysomnography as the gold standard outcome measure and used the Prediction Model Risk of Bias Assessment Tool (Kleijnen Systematic Reviews Ltd) to assess risk of bias and applicability of each included study. Results: Our search retrieved 5479 articles, of which 63 (1.15%) articles were included. We found 23 studies performing diagnostic model development alone, 26 with added internal validation, and 14 applying the clinical prediction algorithm to an independent sample (although not all reporting the most common discrimination metrics, sensitivity or specificity). Logistic regression was applied in 35 studies, linear regression in 16, support vector machine in 9, neural networks in 8, decision trees in 6, and Bayesian networks in 4. Random forest, discriminant analysis, classification and regression tree, and nomogram were each performed in 2 studies, whereas Pearson correlation, adaptive neuro-fuzzy inference system, artificial immune recognition system, genetic algorithm, supersparse linear integer models, and k-nearest neighbors algorithm were each performed in 1 study. The best area under the receiver operating curve was 0.98 (0.96-0.99) for age, waist circumference, Epworth Somnolence Scale score, and oxygen saturation as predictors in a logistic regression. Conclusions: Although high values were obtained, they still lacked external validation results in large cohorts and a standard OSA criteria definition. Trial Registration: PROSPERO CRD42021221339; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=221339(J Med Internet Res 2022;24(9):e39452) doi: 10.2196/39452

2022

Dataset Comparison Tool: Utility and Privacy

Autores
Almeida, JC; Cruz Correia, RJ; Rodrigues, PP;

Publicação
Challenges of Trustable AI and Added-Value on Health - Proceedings of MIE 2022, Medical Informatics Europe, Nice, France, May 27-30, 2022.

Abstract

2022

Process Evaluation of a Mixed Methods Feasibility Study to Identify Hospital Patients with Palliative Care Needs in Portugal

Autores
Antunes, B; Rodrigues, PP; Higginson, IJ; Ferreira, PL;

Publicação
ACTA MEDICA PORTUGUESA

Abstract
Introduction: Evidence shows most patients are not recognised by their attending healthcare professionals as having palliative needs. This feasibility study aimed to aid healthcare professionals identify hospital patients with palliative needs. Material and Methods: Mixed-methods, cross-sectional, observational study. The patient inclusion criteria comprised: age over 18 years old, being mentally capable to give consent judged as such by participating healthcare professionals, and if unable, having a legal substitute to consent, having a diagnosis of an incurable, potentially life-threatening illness. Field notes were taken for reflexive purposes. Outcome measures included: Integrated Palliative Care Outcome scale, surprise question, phase of illness, referral request status, The Eastern Cooperative Oncology Group Performance Status and social needs assessment. An interim data collection period meeting assessed implementation outcomes in each context. A web-based survey was sent to all participating healthcare professionals at the end of data collection period to explore overall experiences of participation and implementation outcomes. Results: Forty-two departments in four hospitals were contacted. The study was presented in nine departments. The field notes were vital to understand the recruitment process and difficulties experienced: time constraints, fear of additional work, department dynamics and organisation, relationships between departments and need of training in palliative care and research. One department agreed to participate. There were six participating healthcare professionals and only 45 patients included. Three participating healthcare professionals responded to the web-based survey. Discussion: The response rate was very low. Legislating palliative care is not enough, and an integrated palliative care plan needs to be implemented at country and institution level. Conclusion: There is an urgent need to provide generalist palliative care training to clinicians.

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